Introduction: Child mortality indices are key element that reflects health Status of societies and inform policy makers to take suitable policies to reduce them. This study was performed to examine the main determinants of under-5 mortality rate (U5MR) in OECD countries in two cross-sections, 2010 and 2013, and the results of them was compared. Material and Methods: This was a cross- sectional study. The data on U5MR,health expenditure, Gross National Income per capita (GNI), Physician and nurses’ density, Ratio of female to male primary, secondary and tertiary school enrollment was gathered from world health organization (WHO) and World bank datasets. Pearson correlation and regression models was used for analyzing the data for years 2010 and 2013. Stata 11 was used for analyzing the data. Results: Pearson correlation was negative for all variable in 2010 and all variables, expect Ratio of female to male secondary enrollment, had negative correlation with U5MR. Regression analysis showed that, all variable, except Ratio of female to male primary enrollment had negative effect on U5MR in 2010. Also, GNI had negative effect on U5MR in 2010 and its coefficient was significant. The β-coefficient of healthcare expenditures was -0.964 and -0.746 in 2010 and 2013, respectively and was statistically significant just in 2010. Two of three variables in which included for women literacy had negative effect on U5MR in 2010 and all of them had negative effect in 2013. Conclusion: The study results showed that all variables, including health expenditures, gross national income per capita, and density of physicians and nurses and female literacy, had invers effect on under-five mortality rate in OECD countries.

Introduction: One ofdiagnostic criteria for Acute Lung Injury and Acute Respiratory Distress Syndrome is pao2/fio2 (PF) ratio 300 for ALI or 200 for ARDS. This criteria requires invasive arterial sampling. Measurement of Spo2/Fio2 (SF) ratio by pulseoximetry may be a reliable non invasive alternative to the PF ratio. Methods and Materials: In a cross sectional study we enrolled 105 sample of patients with ALI or ARDS, to determine the Spo2/Fio2 (SF). Pao2 wasmeasured through arterial blood sampling and Spo2 measured with pulse oximetry and documented within 5 minutes of each other. Results The relationship between SF and PF ratio was described by the following equation: SF=57+0/61PF (P<0/001). Spo2/Fio2 (SF) ratios of 181 and 235 can be substituted pao2/fio2 (PF) ratio of 200 and 300 in ARDS and ALI respectively. The ALI SF cutoff of 235 had 57% sensitivity and 100% specificity, and ARDS, SF cutoff of 181 had 71% sensitivity and 82% specificity. Conclusion Spo2/Fio2 (SF) ratio is a reliable noninvasive marker to determine children with ALI or ARDS and can be used instead of it.

Introduction: Chest pain is a common compliant in children and adolescents visiting the clinic. We assess and analyze the etiology of chest pain among children referred a pediatric cardiology clinic in cardiac center in south west of Iran.Materials and Methods: We assessed children with chest pain who visited our medical center during March 2013 to April 2014. Any case of trauma associated chest pain was excluded from this study. Data were analyzed by SPSS 17.Results: A total of 200 patients (107 male, 93 female; age range (3−17 years) were enrolled into this study. ECG was taken from all patients that 6 patients had abnormal ECG. 43 patients had chest radiograms (39.5%). Echocardiograms were performed in 130 (65%) patients. Overall, idiopathic chest pain was the most common diagnosis (51%). Other associated disorders were musculoskeletal (30%), gastrointestinal (11.5%), pulmonary (3%), cardiac (4.5%).Conclusions: According to our data idiopathic chest pain seems to be the most common cause of chest pain in children. Careful physical examination can be helpful in diagnosis and treatment planning of children suffering of chest pain. Chest pain due to cardiac origin is rare, but it should be considered.

Background Infant mortality rate is widely used to assessing the health status of population in both developing and developed countries. The aim of this study was to identify the main factors affect infant mortality rate in ECO countries for the years 2005 to 2012. Methods A panel data model from ECO countries from 2005 to 2012 used to identify the some of key explanatory variables (GDP per capita, female labour participation rate, public expenditure as % of total health expenditure and total fertility rate) effect on infant mortality rate. These data was obtained from World Bank and World Health Organization. The data analyzed by STATA v.12. Results This study indicated the GDP per capita and public spending had a negative and significant effect on infant mortality in studied countries. A higher total fertility rate is also associated with higher infant mortality. In addition, our analysis showed there is not association between female labour participation rate and infant mortality. Conclusions GDP per capita, public expenditure as % of total health expenditure and total fertility rate were identified as the main determinant of infant mortality in ECO countries in study period. We hope the results of current study provide useful information for health policy- makers to better understand the main factors affecting on infant mortality.

There are no adequate data that evaluate the safety and effectiveness of lowering triglyceride levels in infants. The authors report a neonate affected by familial hyperchylomicronemia, While being investigated for sepsis the serum sample obtained for blood counts was discovered to be lipaemic and the case was subsequently investigated for dyslipidemia. Based on this very abnormal lipid profile compared to her age, we started her on statins. The parents were referred to a dietitian vigorous dietary fat restriction supplemented by fat-soluble vitamins including mixing food with olive oil and giving skimmed dairy products as she is growing. Follow up is ongoing.

Introduction: The purpose of this report was to present a successful treatment approach in an unusual gingival recession as a result of finger sucking traumatic habit associated with high labial frenum. Case Report: A 10-year-old girl presented moderate pain, recession in the mandibular right incisor and finger sucking habit. The performed treatment was: oral hygiene instruction, use of palatal appliance, psychological support and frenectomy. After three years follow up, significant increases in the width of keratinized gingival, root coverage and profits in clinical attachment levels were observed. Conclusion: This case report showed great results in recovery of the periodontal health in a child.

Introduction: α1-antitrypsin deficiency (α1-ATD) is one of the most common genetic disorders in white race, a usual cause of liver disease in children, and hepatopulmonary involvement in children and adult. The aim of this case description is presenting a child with early lung disease without liver parenchymal disorder. Case presentation: We describe a 13 year old boy because of exertional dyspnea, wheezing, productive cough and repeated hospital admission due to bronchopneumonia. There was no immune deficiency, sinusitis and allergic lung disease. There was no history of foreign body aspiration. Cystic fibrosis cause ruled out. Protein electrophoresis and serum level α1-AT evaluation documented α1-ATD. The patient was treated with conservative management. Conclusion: This article suggests that if a child presents with chronic pulmonary symptoms, possibility of α1-ATD should be considered and worked up.

The economic exploitation of children is an insult to humanity. All over the world children continue to work, putting at stake their education, their health, their normal development to adulthood, and even their lives. Millions of them work under hazardous conditions which present dangers to their health, safety and welfare. They toil in mines and quarries, are exposed to agrochemicals in agriculture, squat in crippling positions to weave rugs and carpets, and scavenge in rubbish tips. Too many are enslaved in bonded labour, isolated in domestic service, and traumatized and abused in the commercial sex trade. Today many people and organizations are concerned about child labour. The number of children working in the world today is higher than most people think, although it is difficult to obtain anything more than an educated global estimate. This is firstly because many kinds of child labour are underreported, and secondly because many countries have no desire or incentive to publicize how many of their young people work. Nevertheless, statistical techniques allow us to estimate that 211 million children aged 5 to 14 and an additional 141 million children aged 15 to 17 are “economically active”, i.e. are involved in some form of work.

Introduction: Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in children and the main form of childhood leukemia (75%). ALL different treatment options have a great impact on children weight and appetite. The improving prognosis for children with cancer refocuses attention to long-term outcomes with an emphasis on quality of life. More survival rate allows researchers to evaluate long term complication of ALL and its different treatment options such as endocrine abnormalities for example decreased bone mineral density. METHODS: a systematic web base search was conducted in MEDLINE up to December 2014. We included articles with available abstract in English language, and participants younger than 18 years. Manual searching was done within the reference list of articles. Two reviewers independently reviewed and assessed eligibility criteria, assessed quality, and extracted data. RESULTS: Trace elements concentration decline due to malabsorption or inadequate intake in children with ALL. Osteopenia occurs more frequent in younger children and those who treated with higher doses of corticosteroids. CONCLUSION: The dietary history of ALL patients who are at more risk for fractures and osteopenia should be screened by paying more attention to calcium and vitamin D intake.